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General NPI Number Information
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NPI Number | 1104157106
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Entity Type | Organization
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Legal Business Name | REMEDIOS R. CABANSAG , MD, PA
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 01/15/2010
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Provider Practice Location Address
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Address Line | 11803 SO. FREEWAY SUITE 254
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City | FORT WORTH
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State | TX
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Zip | 76115-0337
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Country | US
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Telephone | 817-551-2963
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Fax | 817-568-1663
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Provider Business Mailing Address
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Address Line | 11803 SO. FREEWAY SUITE 254
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City | FORT WORTH
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State | TX
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Zip | 76115-0337
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Country | US
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Telephone | 817-551-2963
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Fax | 817-568-1663
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Authorized Official
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Title or Position | PRESIDENT,VICE PRESIDENT,SEC/TREAS
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Name | DR. REMEDIOS R. CABANSAG
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Credential | MD
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Telephone | 817-551-2963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D9958
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License Number State | TX
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